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Nutrient Requirements and Optimal Nutrition

Linear and Ponderal Growth Trajectories in Well-Nourished, Iron-Sufficient Infants Are Unimpaired by Iron Supplementation^1,2

³ Division of Child Development and Community Health, Department of Pediatrics, Rady Children's Hospital and University of California, San Diego, CA 92093-0831; ⁴ Center for Human Growth and Development, and Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI 48109-5406; ⁵ Center for Clinical Investigation, Yale University, New Haven, CT 06519; and ⁶ Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile

Iron deficiency remains the most common nutritional deficiency worldwide and supplementation is recommended during periods of high risk, including infancy. However, questions have been raised about possible adverse effects of iron on growth in iron-sufficient (IS) infants and the advisability of across-the-board iron supplementation. This study examined whether short- or long-term growth was impaired in IS infants who received iron supplementation. From a longitudinal study of healthy, breast-fed, low- to middle-income Chilean infants randomly assigned to iron supplementation or usual nutrition at 6 or 12 mo, we retrospectively identified infants meeting criteria for iron sufficiency at the time of random assignment (n = 273). Using multilevel analysis, ponderal and linear growth were modeled before, during, and after iron supplementation up to 10 y in 3 comparisons: 1) iron supplementation compared with usual nutrition from 6 to 12 mo; 2) iron supplementation compared with usual nutrition from 12 to 18 mo; and 3) 15 mg/d of iron as drops compared with iron-fortified formula (12 mg/L). Growth trajectories did not differ during or after supplementation indicating no adverse effect of iron in any comparison. These results suggest that, at least in some environments, iron does not impair growth in IS infants.

^* To whom correspondence should be addressed. E-mail: sgahagan{at}ucsd.edu.

Manuscript received 8 October 2008. Initial review completed 24 November 2008. Revision accepted 25 August 2009.

Published online 23 September 2009.